Two recent papers in The American Journal of Clinical Nutrition (September 2011) show that taking protein during and after exercise helps you recover faster from intense workouts. A third paper, from Denmark, shows that taking protein during exercise does not stimulate muscle recovery until after a person stops exercising. (Medicine & Science in Sports & Exercise, September 2011). Therefore, the best time to load with protein is immediately after you finish your intense workouts.

THE HARD-EASY PRINCIPLE: To increase strength, speed and endurance, athletes have to exercise intensely enough to damage their muscles. Then when their muscles heal, they are stronger than before the muscles were damaged. Training for sports is done by taking a workout that is intense enough to cause the muscles to feel a burn during the workout, feeling sore on the next day (DOMS - Delayed Onset Muscle Soreness), then exercising at a relaxed pace for as many days as it takes for muscles to feel fresh again. This is called the Hard-Easy Principle and is followed to some degree by virtually all competitive athletes.

RECOVERING FASTER MAKES YOU STRONGER AND FASTER: Obviously if an athlete can recover faster, he can do more intense workouts which will make him a better athlete, and taking protein during and after the intense workouts helps an athlete recover faster. Taking protein before a workout does not increase recovery rate or improve athletic performance.

The first of the studies in The American Journal of Clinical Nutrition, from McMaster University, showed that a large, single dose of whey protein (25 g) taken immediately after an intense workout helps muscles recover faster than multiple smaller doses (2.5 g) 10 times over an extended period. The message is to eat lots of protein-containing food immediately after your workout. It does not need to be any special protein supplement; proteins extracted from food are no better than ordinary protein-containing foods.

LEUCINE: The second study, from the US Army Research Institute of Environmental Medicine, showed that protein containing twice as much of the protein building block (amino acid), leucine hastened muscle healing much faster than a lower dose of leucine. Leucine is found in the highest amounts in egg whites, dairy products, beef, pork, chicken and fish. Since fat contains no leucine, athletes should choose the leanest protein sources. If you are a vegetarian, eat soybeans as they have the highest leucine content of any plant food. Other good sources of leucine include lentils, cowpeas, chickpeas, nuts and seeds (peanuts, almonds, walnuts, sesame seeds flax seeds and so forth). Most fruits and vegetables are low in protein and thus are low in leucine, but some such as asparagus are good sources.

CARBOHYDRATE WITH PROTEIN: Other studies show that taking carbohydrates with the protein helps muscles recover even faster. Carbohydrates cause the pancreas to release large amounts of insulin which drives the protein building blocks into muscles even faster and hastens recovery even more. Therefore athletes can recover faster by taking immediately after their most-intense workouts:
• protein (meat, fish, chicken, or corn and beans) plus
• carbohydrates (bakery products, pastas, and fruits).

SUMMARY: Train for sports by taking an intense workout, feeling sore on the next day and going at low- intensity for as many days as it takes for your muscles to feel fresh again. Recover faster from your intense workouts by eating foods rich in proteins and carbohydrates immediately after you finish your intense workouts.

Dear Dr. Mirkin: Can I lower cholesterol by diet alone, without taking drugs?

Yes! The most effective way to lower cholesterol is to eat a diet full of foods that block the absorption of cholesterol and keep your liver from making cholesterol:
• viscous fibers including oats, barley and psyllium;
• nuts, beans and soy products;
• specialty margarines containing plant sterols
(Journal of the American Medical Association, August 24/31, 2011). Eating these foods that specifically block the absorption and manufacture of cholesterol is more effective in lowering cholesterol than a control diet of low- cholesterol/high fiber foods. Those who followed this diet had their bad LDL cholesterol drop four times lower (13 percent) than those who followed the conventional low cholesterol/high fiber diet (3 percent). Most people can lower their cholesterol enough to prevent heart attacks with this diet alone. High doses of statin drugs can lower cholesterol by 20 percent, but they have many adverse side effects.

HOW CERTAIN PLANT FOODS LOWER CHOLESTEROL: The foods in this diet contain plant stanols that reduce the absorption of cholesterol from animals in the intestines. They are also high in soluble fiber that cannot be absorbed in the intestinal tract. Soluble fiber passes to the colon where bacteria ferment it into short chain fatty acids. These short- chain fatty acids are absorbed from the colon and travel in the bloodstream to the liver, where they block the manufacture of cholesterol.

HOW TO DO IT:
1) Eat oatmeal, oat bran or psyllium cereal in the morning in place of your regular breakfast;
2) Eat and drink soy products instead of dairy products;
3) Add nuts, beans and other seeds to every meal; and
4) Use nuts as your exclusive food for snacking.

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Dear Dr. Mirkin: How does lack of exercise cause diabetes and heart attacks?

Reducing your physical activity by just 50 percent for just three days, without changing your diet, doubles the rise in blood sugar levels after meals (Medicine & Science in Sports & Exercise, June 2011). This shows that reducing exercise
• interferes with your ability to control blood sugar levels,
• plays a key role in the development of type 2 diabetes and
• markedly increases risk for heart attacks and strokes.
A single bout of moderate exercise lowers blood sugar rise after meals.

MECHANISM: A high rise in blood sugar causes sugar to stick to the surface membranes of cells. Once there, sugar cannot detach itself. It is converted by a series of chemical reactions from glucose to fructose and eventually to sorbitol that destroys the cell to damage every cell in your body. That's why diabetics suffer from loss of function of every organ in their bodies including nerves, brains, arteries, hearts, lungs, bones, joints, kidneys and everything else.

Resting muscles cannot remove sugar from your bloodstream without insulin. However when a muscle starts to contract, it suddenly can remove sugar from the bloodstream without needing insulin. It is absolutely incredible how contracting a muscle suddenly lowers blood sugar levels. This effect is maximum when the muscle is contracting, has a greater effect in lowering blood sugar levels with intense exercise, and maintains near-maximum efficiency for up to an hour after a person finishes exercising. Then the benefit of exercise gradually decreases until it disappears completely in about 17 hours.

MY RECOMMENDATION: Everyone capable of exercising without damaging his or her health should exercise every day for at a least an hour.

About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities.
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